Abstract | BACKGROUND: Harvest of more than one CD34+ stem cell transplant has become the standard, to ensure the option for a second autologous transplantation in patients with relapsed or progressive multiple myeloma (MM). Additional administration of the CXCR-4 inhibitor plerixafor has been shown to increase the efficiency of CD34+ stem cell harvest. However, the algorithm when to apply plerixafor is still under debate. STUDY DESIGN AND METHODS: In this retrospective study, 46 MM patients were categorized into four groups according to their CD34+ stem cell count in peripheral blood (PB) and mobilization with or without plerixafor: Group A comprised poor mobilizers with CD34+ cell counts of fewer than 20 × 10(6) /L in PB. Group B included inadequate mobilizers with CD34+ cell counts of 20 × 10(6) /L or more in PB and a low CD34+ stem cell yield in the first leukapheresis session. Patients receiving plerixafor preemptively (Group A1) and as a rescue strategy (Group B1) were compared to patients continuing stem cell collection with granulocyte-colony-stimulating factor alone (Groups A2 and B2). RESULTS: In both, the preemptive and the rescue settings, plerixafor enhanced the CD34+ stem cell yield significantly. Poor mobilization and administration of plerixafor was not associated with delayed engraftment. CONCLUSION: Our data demonstrate that administration of plerixafor is safe and effective and facilitates a significantly higher CD34+ stem cell harvest. Based on the presented data, we propose an algorithm for the use of plerixafor for CD34+ stem cell mobilization and harvesting in poor mobilizing myeloma patients.
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Authors | Jian Cheng, Michael Schmitt, Patrick Wuchter, Eike C Buss, Mathias Witzens-Harig, Kai Neben, Michael Hundemer, Jens Hillengass, Renate Alexi, Hartmut Goldschmidt, Bao-an Chen, Anthony D Ho, Anita Schmitt |
Journal | Transfusion
(Transfusion)
Vol. 55
Issue 2
Pg. 275-83
(Feb 2015)
ISSN: 1537-2995 [Electronic] United States |
PMID | 25117969
(Publication Type: Clinical Trial, Journal Article)
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Copyright | © 2014 The Authors. Transfusion published by Wiley Periodicals, Inc. on behalf of AABB. |
Chemical References |
- Anti-HIV Agents
- Benzylamines
- CXCR4 protein, human
- Cyclams
- Heterocyclic Compounds
- Receptors, CXCR4
- plerixafor
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Topics |
- Adult
- Aged
- Anti-HIV Agents
(administration & dosage, adverse effects)
- Autografts
- Benzylamines
- Cyclams
- Female
- Hematopoietic Stem Cell Mobilization
- Heterocyclic Compounds
(administration & dosage, adverse effects)
- Humans
- Leukapheresis
(methods)
- Male
- Middle Aged
- Multiple Myeloma
(blood, therapy)
- Peripheral Blood Stem Cell Transplantation
- Receptors, CXCR4
- Retrospective Studies
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